Can your liver heal after drinking? What the NHS says about each stage

The three stages of alcohol-related liver disease

The NHS says alcohol-related liver disease (ARLD) is damage to the liver from drinking too much alcohol over a long time, and that it develops over months or years. It describes three stages, depending on how serious the damage is:

How long does it take for the liver to heal?

This is the question people search for most, and the honest answer is that the NHS does not give a set number of days or weeks. What it says is that if you stop drinking, your liver can often recover, that fatty liver can usually recover, and that the later stages are harder to treat and more likely to have serious complications.

What the NHS ties recovery to is the stage, and early stages often have no symptoms. To find out, a doctor may check your liver with blood tests, scans such as an ultrasound and sometimes a biopsy. Pages that promise your liver will "reset" in a fixed number of days are not quoting the NHS.

Symptoms to watch for

The NHS says ARLD does not always cause symptoms in the early stages. Early symptoms may include feeling very tired, feeling less hungry than usual, losing weight without trying, feeling or being sick, and pain or discomfort in the upper right side of the tummy.

As the damage gets worse, symptoms may include yellowing of the skin or the whites of the eyes (jaundice), a high temperature, swelling of the tummy from fluid, swollen legs, shaking hands, blood in vomit or poo, and problems with confusion, concentration and memory.

The NHS says to get medical help if you think you might have ARLD and not to wait for symptoms to get worse. It says to call 999 or go to A&E if you are worried alcohol may be affecting your liver and you vomit blood or your poo is black and sticky, you have tummy pain, you have difficulty breathing, or you feel suddenly confused, dizzy or find it hard to stay awake.

Who is more at risk

The NHS says ARLD is caused by regularly drinking too much alcohol, and that it develops more quickly and at lower drinking levels in women than in men. You are more likely to develop it if you drink too much and you:

• already have a liver condition, such as hepatitis C;
• have diabetes, especially type 2;
• are overweight or obese;
• have a family history of alcohol-related diseases and addiction.

How doctors check your liver

To diagnose ARLD, the NHS says a doctor will ask about your drinking and how it affects your life, and may do tests: blood tests to check your liver health, scans such as an ultrasound or CT scan, and sometimes a liver biopsy, where a small sample of the liver is taken for testing.

If you are worried, being honest about how much you drink helps the doctor judge the risk. Our standard drink calculator can turn your usual drinks into units or standard drinks before the appointment.

Protecting your liver: drinking less or not at all

The NHS says drinking less, or not drinking at all, reduces your risk of ARLD and helps prevent serious liver damage. If you do drink, it recommends no more than 14 units a week, spread across 3 days or more; it notes that half a pint of beer or a single shot of spirits each have about 1 unit.

For anyone who already has ARLD, the NHS says the aim of treatment is usually to stop drinking completely, whatever the stage. A GP or specialist alcohol service can help you reduce your drinking safely, with talking therapies, medicines and support groups.

One warning matters more than any other here: the NHS says that if you regularly drink too much alcohol, it can be very dangerous to stop suddenly, so get medical help before you try. Our guide to what happens when you stop drinking explains why.

Common questions

When to get help

This site offers self-help tools and information, not medical advice. Talk to a doctor, or call one of the lines below, if:

• you feel shaky, sweaty, sick or anxious when you haven't had a drink;
• you find it hard to stop once you start, or you want to cut down and can't;
• drinking is causing problems with your health, work or the people close to you.

Before you stop: It can be very dangerous to stop drinking suddenly if you are dependent on alcohol. If you get withdrawal symptoms, get medical help before you try to stop drinking.

Sources

1. Alcohol-related liver disease (ARLD). NHS. nhs.uk
2. Alcohol units. NHS. nhs.uk
3. Alcohol-use disorder. NHS. nhs.uk